THE EFFECT OF EARLY AMBULATION ON PATIENT COMFORT AND DELAYED BLEEDING AFTER CARDIAC ANGIOGRAM - A PILOT-STUDY

Objective: To examine the effects of ambulation at 3 versus 6 hours on delayed bleeding, pain, and anxiety in patients after cardiac angiogr am. Design: Experimental, pretest posttest, random assignment. Setting : Western Canadian University-affiliated tertiary care hospital. Patie nts: Thirty-nine patients who underwent cardiac angiograms. Outcome Me asures: Delayed bleeding, pain, and anxiety. Intervention: The experim ental group ambulated at 3 hours after cardiac angiogram; the control group ambulated at 6 hours. Delayed bleeding was evaluated by sanguino us drainage through a standard gauze pressure dressing and/or the pres ence of a palpable hematoma greater than 5 cm in width. Melzack's Pres ent Pain Intensity Scale and Spielberger's State Anxiety Inventory wer e used to evaluate patient comfort at 2, 4, and 7 hours after angiogra m and the next day. Results: None of the patients experienced any dela yed bleeding. Student's t test was used to compare pain levels and anx iety scores. In addition, repeated measures analysis of variance was a pplied to pain scores taken at 4 hours, 7 hours, and the next day. The 2-hour observation data were used as a covariate and a basis for comp arison of pain at the next three observations. Patients ambulating ear ly had significantly less pain overall (p < 0.005) and less back pain at 4 and 7 hours after angiogram (p < 0.05). There was no significant difference in the mean anxiety scores. Conclusion: The significant dec rease in back pain of patients who ambulated earlier demonstrates the need to consider patient comfort as well as the potential risks and se quelae of delayed bleeding.